Silver Diamine Fluoride Helps Prevent Emergency Visits in Children with Early Childhood Caries

Early childhood caries remains a worldwide disease and often requires treatment under sedation or general anesthesia, with long waitlists. Silver diamine fluoride has been shown to arrest caries lesions. The purpose of this study was to determine whether silver diamine fluoride (SDF) application reduces emergency visits by waitlisted patients with early childhood caries (ECC). Waitlisted patients aged zero to 71 months with ECC who were treated with SDF were enrolled at the University of Florida's NCEF Pediatric Dental Center; their cumulative incidence of dental emergencies were compared with children who were waitlisted during the 16 months preceding the introduction of SDF. Data from patient records on demographics, dental visits, SDF placement, and caries arrest were abstracted. Bivariate analyses and multiple logistic regression modeling were performed. Participants included 97 patients treated with SDF and 216 not treated with SDF. The cumulative incidence of dental emergencies was approximately 80 percent lower in the SDF group than in the comparison group (4.1 percent versus 17.6 percent; adjusted odds ratio equals 0.18; 95 percent confidence interval equals 0.06 to 0.54); 81 percent of SDF-treated surfaces were arrested at a follow-up visit. Silver diamine fluoride helps reduce emergency visits for children with early childhood caries while on treatment waitlists and confirms the effectiveness of SDF for caries arrest in primary teeth.